Book review

I am delighted to have been invited to present a discussion of Marc Lavoie’s Post-Keynesian Economics: New Foundations. I was contemplating whether to give my short review, ‘it’s a brilliant book, you must buy it’, or my longer and more considered review, ‘it’s a brilliant book, you must buy it and I wish I had written it’! However, I fear I must justify these conclusions a little more, and I hope you will excuse me if I use this opportunity to range a little more widely than is usual in a book review to reflect on the state and future of post-Keynesian economics. Economists, certainly neoclassical economists, never pay much if any attention to economic methodologists except to the extent that they may have read, in passing, Milton Friedman’s (1953) classic, but very misleading, ‘The methodology of positive economics’. This reassures them that no matter how absurd or unrealistic are the assumptions of their models, they represent an advance in the subject so long as the models are not refuted by empirical testing. Of course, the qualification that they need to pass empirical testing is often implicitly interpreted as ‘sometime in the unspecified future’, or is simply overlooked altogether. But perhaps we should not be surprised that economic methodologists, in effect, write solely for each other, because this is certainly true of those of the physical sciences. There are no courses in the philosophy of science given by the core natural science departments at, say, the University of Cambridge. They are given by a separate department, namely the History and Philosophy of Science, and I expect this is true in most, if not all, universities. This is not surprising because, as Thomas Kuhn (1970) argued convincingly many years ago in The Structure of Scientific Revolutions, students of an academic discipline learn the correct way of analysing a problem, and indeed what constitutes a legitimate research topic, by ostentation or tacit knowledge. In other words, methodology is acquired by learning-by-doing. This is based on the prevailing paradigm (or disciplinary matrix, I should perhaps say). Kuhn’s approach, now widened into what may be broadly called the sociology of knowledge, stresses the great importance of the textbook as the key to the perpetuation of a paradigm. The student, and future researcher, acquires an understanding of his subject through the acquisition of knowledge in the textbooks and the undertaking and answering, or solving, of the questions usually at the ends of the chapters. He (or she)

l68 REVIEWS OF BOOKS.
The Pocket Therapist. By Thos. Stretch Dowse,M.D* Pp. 192. Bristol: John Wright & Co. 1897.?The author makes so ample an apology for " this small and apparently trivial work," and for " its insufficiency and inadequacy," that we have little need to point out its errors of omission. It contains a record of much ripe experience, and therefore cannot fail to be useful to the inexperienced ; but why the latter should not go to a complete text-book or a monograph for information we fail to see.
There appears to be little need for a book like this, which in so small a space professes to be a guide to therapeutics, to health-resorts, poisons and their antidotes, and clinical diagnosis. We wonder what mysteries are hidden behind such names as Branalcane, Salycilic (sic) Valsol, Neboline.
Diet Chart and Alimentary Index. Suggested by M. J-Kenny.
Bristol: John Wright & Co. 1897.?Each page of this book is a list of ordinary foods and drinks, with a space for marking those which are suitable to the case : the page is torn out and given to the patient. The list is by no means complete, and we fail to see on what principle the selection has been made-The alimentary index is inside the covers, and we venture to think that this is the most useful part of the book. Some formulae for making broths, &c., are on the back of each chart-Surely the beef tea need not have the meat excluded by strait' ing : why should not the whole of the meat be retained ? Gynaecology in Berlin. By H. Macnaughton-Jones, M.D-Pp. 28. London: John Bale,-Sons and Danielsson, Limited-1897.?Reprinted from the British Gynecological Journal, tlns forms an interesting little book, containing in a concise form many methods which are not usually practised by English surgeons. The observations are taken from the clinics ?* Martin, Olshausen, and Landau, whose work is in many respects original. It is well worth reading, and is freely illustrated wit'1 helpful plates. Our Baby. By Mrs. Langton Hewer. Fifth Edition. PP' vii., 140. Bristol: John Wright & Co. 1897.?We so recently reviewed the previous edition, that a notice need hardly be give11 to this work. The book is "revised," but is practically the same as the last edition. It  The practitioner will especially appreciate Chapter xvii., in whi the ocular diseases and symptoms liable to accompany dinu 0rganic brain lesions and diseases of the spinal cord have been Seated more fully, whilst there has also been introduced an account of the " Functional Derangements of Vision." An excellent account of tumours of the orbit and neighbouring cavities is to be found in Chapter xix., the purely pathological aspect of that class of diseases being avoided. The aim of the author to say all.he ought, without saying all he might, has been successful; the result being an exceedingly well-written book, 'hat, taking into consideration its size, cannot, in our opinion, be ^celled. ,?pic, one which Dr. Walsh has made his own, the association et\veen excretion and dermatitis.
That the skin suffers as 0lle of a group of excretory organs is abundantly demonstrated, aj1(i the action of certain internal remedies on the skin is explained. It is interesting to note " that any internal irritant hich inflames the skin may be suspected of inflaming other excretory outlets," and "that the law of excretory irritation as a wide application to general pathology." s booklet seems to be the recommendation of "multiple near scarification" by means of a mincing machine with lxteen blades, set g-V inch apart. From our own experience? ttd from enquiries?no one seems to have come across any of ,e "very many cases of lupus" so completely treated "that e patients have remained absolutely free from the disease for Series of years." Dr. Squire appears to overlook the fact . a_t many cases of so-called lupus erythematosus are but the Clpient stages of lupus vulgaris. Glasgow : John Morgan & Co. 1897.?Dr. Erskine's Pea contains many pleas, and space will not permit us to 17? criticise them. Though many of the opinions expressed by the author are fully warranted by facts, we do not think the remedies he recommends would cure the numerous evils that exist.
We are not educated sufficiently yet in socialism?to use the term in its widest sense?to adopt a State medical service.
Thirty-sixth Annual Report of the Cincinnati Hospital. Cincinnati : The Commercial Gazette Job Print. 1897.?The most noteworthy topic we have noticed in this volume of 276 pages is a report on a series of cases of syphilis treated with Coley's mixed toxins. In some of the cases the result was good, the drug acting as quickly and as well as mercury. The report shews " the present of the remedy?its past is very young, its future yet unveiled. Time alone can fathom the outcome of these cases." King's College Hospital Reports. Vol. III. London : Adlard and Son. 1897. Old King's men will take more special interest in this volume in consequence of the obituary notice of Sir George Johnson, and the description of the new ophthalmological theatre which forms his memorial. Dr. Raymond Crawfurd, in a good paper on Graves's disease, emphasises the neurotic theory as opposed to the popular one of thyroid toxaemia, and he has great expectations that the influence of suggestion on the disordered mental state may prove to be of value in the treatment of the disease. usual, full of interest. The first two papers are reminiscences of two well-known surgeons: one, Professor Humphry, Cambridge, had been a student at the hospital in the days when Sir James Paget was curator of the museum; the other, Mr. Morrant Baker, a man well known to all students of more modern times. These papers will be read with a sad interest by all old Bartholomew's men. One of the most striking and almost unique papers in this volume is a collection of aphorisms of Dr. Gee. They have been collected and edited by Mr. Horder and revised by their author. When reading them many will feel that they are again standing around the bedside of the patient and listening to Dr. Gee's remarks on the diagnosis and treatment of the case. Some cases of enteritis which simU' lated intestinal obstruction are recorded by Dr. Mitchell. In three out of the four cases the patients were operated on for intestinal obstruction.
A very valuable paper on hernia of the vermiform appendix has been contributed by Mr. McAdam Eccles, in which he has given the records of a large number of such cases. As most of the papers are well worth reading, it seems unnecessary to refer to them in detail. They are on both medical and surgical topics. The volume contains the usual table ox ca.ses, with interesting remarks on the more important ones, and a description of specimens added to the museum.
The Westminster Hospital Reports. Vol. X. London : J. & A. Churchill. 1897.?This volume is a welcome addition to the Senes, for it contains the records of an unusually interesting number of cases of the varied description necessarily found in ' Reports." The accounts of post-mortem examinations are very ; but we think it desirable that in future issues a greater Prominence should be given to the clinical aspects of the disease by more fully tabulating some of the chief symptoms found in 'he various diseases?as in Table F ^'lills has a thoughtful paper on diagnosis; and, besides other lormal papers contributed to the regular discussion, there are reports of isolated cases. A discussion on the Rontgen rays is ^eluded, but this is hardly as satisfactory; the ground is too gifting, and some of the conclusions are already out of date.
Xw0 cases of the rare condition of floating liver are reported; 5^d there is a good sprinkling of interesting clinical material. "e printer's work has been excellently done. ~ Transactions of the New York Academy of Medicine. Second reries. Vol. XI. Printed for the Academy. 1895.?This ls a stout volume of over 600 pages, which contains many Papers on all branches of medicine read before the Academy in A reflection which strikes us, on looking through these ransactions two years subsequently, is what a small amount of no\vledge is added to our stock by all this work. Thus, there are three elaborate papers on scurvy in infants, not one of which Soes beyond what Cheadle and Barlow had already established, he papers were no doubt interesting at the time, insomuch as ney served to impress on the audience the clinical features and J^atment of the malady, but seem hardly worth printing.
here is the usual sprinkling of what can only be called oddities ?* rnedical thought. Thus, Dr. Achilles Rose advocates Greek Is the international language of physicians. Again, Dr. Van leet examined, by a somewhat primitive method, the eyes of a n^rnber of children in reformatories, and finding a great number 0 errors in refraction, comes to the conclusion that defective Eyesight is a factor in the production of crime. He does this, ??> without attempting to determine whether the percentage of children with defective vision in these reformatories is greater than that in public schools and institutions not reformatories. Such are the whimsicalities of specialism. Philadelphia: Wm. J. Dornan. 1896.?The science and art of gynaecology owes much of its advance to trans-Atlantic operators, and every volume published by the American Gynecological Society bears witness to the originality of its members. The present volume is in nowise behind i^5 predecessors, and everyone interested in the subject will find irl these pages a collaboration of the most careful and highly successful work in this branch of surgery. We cannot specify the different articles treating of so many varied subjects, but as a whole the book is characterised by profound research and literary merit, and the writers must be regarded as pioneers 01 the operative treatment of diseases of women.
Transactions of the Obstetrical Society of London. Voh XXXVIII. London: Longmans, Green, and Co. 1897.?? the many interesting communications contained in this volume,-^ is only possible to mention a few of the cases and papers contributed, one of the most important subjects dealt with being deciduoma malignum. Mr. Rutherford Morison and Dr.
Herbert R. Spencer each reported a case. Mr. John D. Malcolm narrated a case of malignant disease of the uterus, with numer-?us deposits in the lungs, and death following an abortion; ^hile Dr. T. W. Eden presented a paper, in which he criticised the whole subject, and pointed out several weak points in the cases of this affection described by continental and other observers, pointing out that plasmodia resembling the multinucleated syncytial masses have been found in sarcomata unconnected with pregnancy, and that the transition from Placental villi to the structures composing these tumours has not been demonstrated; he states that proof of two points is necessary to the acceptance of the theory that these tumours are caused by the growth of decidual elements of partly maternal and partly foetal origin, the first being the connection of the growth with a preceding pregnancy, and the second its development from structures which may be definitely recognised as Placental relics. The interesting discussion which followed must be read in the original; but while the pathological changes nearly 200 less than last year, and we are informed that "with the growing clearness of conception, on the part of the editors, of the exact nature of the professional need there has been a corresponding recognition of the necessity of keeping the epitomization within the limits allotted to previous issues." It forms still a very large but handsome and well-illustrated volume, of which the publishers and editors may well be proud. The first subject dealt with is typhoid fever, and some twenty-seven pages are devoted to this topic. Last year we took occasion to comment uPon the fact that the Widal test had been ignored, but now we come upon it as the most important contribution to the progress of internal medicine, and Drs. Pepper and Stengel state that " for our own part, we have become so thoroughly convinced of the value of the test that we should hesitate to diagnose typhoid fever in any case in which repeated examinations, made in approved fashion, failed to reveal agglutination.' A table is given comprising over two thousand cases by various observers, and it demonstrates very conclusively the great diagnostic value of the reaction, correct results having been obtained in 96.5 per cent, of the cases. The diazo-reaction of Ehrlich has at last been considered worthy of note, and is reported to have " a negative diagnostic value," as also to be of some aid in prognosis, for, "if found in the 1st, 2d, or 3d days, or if it disappears by the end of the 2d or 3d week, the prognosis is favorable," whereas, " if constant to the end of the 4th week, it is more uncertain and relapse likely." In the domain of treatment the authors note the further advances of serum therapeutics; but although some favourable cases of treatment of typhoid by an antitoxic serum have been recorded, yet there is no certainty of success in this direction. The purgative method appears to be diminishing in popularity, but the cold-water treatment maintains its position, and operative interference in the 1 or 2 per cent, of cases of perforation has been successful in a few cases. In the case of tuberculosis there is as yet little certainty, notwithstanding the favourable reports of the followers of Maragliano, of Paquin, and of Koch. The best results seem to be always obtained by the persons who have produced the serum, but the results of experimental work in serum-therapy are more definite and satisfactory than the reports of its clinical use seem to indicate. It is said that " the Schott method for the treatment of heart-disease is still exciting considerable discussion. In general, the evidence is favorable, although warnings against its indiscriminate use are not lacking. The Rontgen rays have been employed for the determination 01 the alterations produced in the size of the heart, and Schott points out the necessity for a consideration of relative distances between the Crookes tube, the patient, and the photographic plate.
The distance between tube and plate has always been one-half metre, experience having shown that this distance reproduces the natural size of the heart. Photographs and diagrams of the fluoroscopic image are not only a valuable addition to physical diagnosis, but they at the same time show in a most trustworthy way the process which takes place in the heart. The screen appears to give the best results.
The Medical Annual. Bristol: J. Wright & Co. 1898.?An enormous amount of information is contained in this volume-In fact it gives us all that is worth knowing about the medical and surgical novelties of the past year. The staff of contributors includes many men of great experience in their special departments of work, and they have well performed their heavy task of abstracting and editing. The volume is well illustrated, and is, in every way, a valuable book.